CHANGES IN PAIN AND DISABILITY IN PATIENTS WITH SHOULDER PAIN AFTER THREE MONTHS OF DIGITALLY DELIVERED EXERCISE AND PATIENT EDUCATION

OBJECTIVE: To describe and examine potential predictors of changes in pain and disability in patients with shoulder pain who have completed 3 months of digitally delivered treatment comprising exercise and patient education. DESIGN: Retrospective cohort study (clinicaltrials.org Nr: NCT05402514). SUBJECTS: Patients with shoulder pain who completed treatment (n = 682). METHODS: Primary outcome was change in shoulder pain (numerical rating scale 0–10; minimal clinical important change: at least 2 points). Pain and disability were reported on the Shoulder Pain and Disability Index. Changes in outcomes were analysed with paired sample t-tests. Association with potential predictors (sex, age, education, body mass index, physical activity, symptom duration, baseline pain/function, and treatment adherence) were explored with linear regression models RESULTS: Statistically significant improvements were found for all treatment outcomes. Minimal clinically important change in pain was reached by 54.5% (n = 372). Higher baseline level of symptoms, short symptom duration, and high treatment adherence were associated with greater changes. CONCLUSION: Patients with shoulder pain reported significant reductions in pain and disability following treatment, but the clinical relevance of the improvements has not been confirmed. Satisfactory treatment adherence, higher baseline pain and shorter symptom duration predicted larger improvements. A control group is needed to evaluate the actual effect of the treatment. LAY ABSTRACT Shoulder pain can be treated through exercise and patient education, which is often delivered by physiotherapists and other healthcare professionals. This study examined how shoulder pain and disability change following 3 months of digitally delivered treatment with exercise and patient education. Reductions in shoulder pain and disability were found after completion of treatment. However, these reductions only reached clinically meaningful levels (a change that is experienced as real change by patients) in half of the patients treated. Larger improvements were associated with the following factors: complying with treatments as prescribed; higher levels of pain at the start of treatment; and shorter symptom duration. In summary, patients appear to improve following digitally delivered treatment for shoulder pain, especially with more severe initial symptoms. Yet, approximately half of all patients do not experience meaningful changes in pain and disability. Further studies with control groups are needed to investigate the actual effect of the treatment.